Surgical management of biliary malignancy.
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ABSTRACT:
SUBMITTER: Kingham TP
PROVIDER: S-EPMC8022290 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
Publications
Surgical management of biliary malignancy.
Kingham T Peter TP Aveson Victoria G VG Wei Alice C AC Castellanos Jason A JA Allen Peter J PJ Nussbaum Daniel P DP Hu Yinin Y D'Angelica Michael I MI
Current problems in surgery 20200630 2
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Project description:ObjectivesWe aimed to analyze the risk factors for management failure of BC after pediatric liver transplantation (pLT) by retrospectively analyzing primary pLT performed between 1997 and 2018 (n = 620 patients).ResultsIn all, 117/620 patients (19%) developed BC. The median (range) follow-up was 9 (1.4-21) years. Patient survival at 1, 5 and 10 years was 88.9%, 85.7%, 84.4% and liver graft survival was 82.4%, 77.4%, and 74.3% respectively. Graft not patient survival was impaired by BC (p = 0.01). Multivariate analysis identified the number of dilatation courses > 2 (p = 0.008), prolonged cold ischemia time (p = 0.004), anastomosed multiple biliary ducts (p = 0.019) and hepatic artery thrombosis (p = 0.01) as factors associated with impaired graft survival. The number of dilatation courses > 2 (p < 0.001) and intrahepatic vs anastomotic stricture (p = 0.014) were associated with management failure. Thus, repeated (> 2) radiologic dilatation courses are associated with impaired graft survival and management failure. Overall, graft but not patient survival was impaired by BC.
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